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General NPI Number Information
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NPI Number | 1831464403
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Entity Type | Organization
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Legal Business Name | HALA KOUDSI M.D., INC
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Dates
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Enumeration Date | 03/15/2012
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Last Update Date | 03/15/2012
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Provider Practice Location Address
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Address Line | 3655 LOMITA BLVD SUITE 215
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City | TORRANCE
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State | CA
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Zip | 90505-3931
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Country | US
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Telephone | 310-378-8885
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Fax | 310-378-4248
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Provider Business Mailing Address
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Address Line | 3655 LOMITA BLVD SUITE 215
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City | TORRANCE
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State | CA
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Zip | 90505-3931
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Country | US
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Telephone | 310-378-8885
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Fax | 310-378-4248
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Authorized Official
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Title or Position | OWNER
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Name | MS. HALA KOUDSI M.D.
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Credential | M.D.
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Telephone | 310-378-8885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A38441
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License Number State | CA
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